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Advanced • CHAIN OF CUSTODIDECORD <br /> --- %' of <br /> GevEnvirvnmental, Inc Date ��I� -6� page �.._ � <br /> 837 Shaw Road- Stockton, California- 95215 - (209)467-1006- Fax (209) 467-1118 <br /> Cilerrt `� Project Manager Tests Required <br /> e-1 <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> j AGE �� <br /> Protect Name ��I�����s fa k1 � Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No of ,mak �,y Notes <br /> Number Description Goths <br /> Comp Grab Air <br /> Fri-1O tc tp' ' d�c5 `..n1� <br /> IL Is ( <br /> Si - 20 it 2a' L%Igo <br /> QI _ 25' (L 2S J lbc-5' <br /> &2— .5 C <br /> Daterrime <br /> e inquis ( + nit re <br /> Received y Ipnature rJ J-O S/ 11�G^ <br /> Relinquished iay gnature) Received by (Signature) DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) - Data(Trme <br /> Dispatched by (Signature) Datelfirne Received for Laboratory by Date rime - <br /> 62- <br /> Method of Shipment t +- Laboratory eine 6�1 7�� <br /> Cott �]Y1x'KI YI <br /> I hereby authorize the performance of the above Indicated work <br /> Special Instructions �F—F—� V D <br /> c.� <br />